The Clinical and Economic Burden of Newly Diagnosed Alzheimer’s Disease in a Medicare Advantage Population

• Published in: American journal of Alzheimer's disease and other dementias Vol. 28; no. 4; pp. 384 - 392
• Main Authors: Suehs, Brandon T., Davis, Cralen D., Alvir, Jose, van Amerongen, Derek, PharmD, Nick C. Patel, Joshi, Ashish V., Faison, Warachal E., Shah, Sonali N.
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA SAGE Publications 01.06.2013
• Subjects: Aged; Aged, 80 and over; Alzheimer Disease - diagnosis; Alzheimer Disease - economics; Alzheimer Disease - epidemiology; Comorbidity; Cost of Illness; Current Topics in Research; Female; Health Care Costs - statistics & numerical data; Health Expenditures - statistics & numerical data; Health Services - economics; Health Services - statistics & numerical data; Humans; Insurance Claim Review - economics; Insurance Claim Review - statistics & numerical data; Longitudinal Studies; Male; Medicare Part C - economics; Medicare Part C - statistics & numerical data; Retrospective Studies; United States - epidemiology; cost of care; Alzheimer’s disease; comorbidity burden; medicare; health care resource utilization
• DOI: 10.1177/1533317513488911
• ISSN: 1533-3175

Background/Rationale: Alzheimer’s disease (AD) represents a serious public health issue affecting approximately 5.4 million individuals in the United States and is projected to affect up to 16 million by 2050. This study examined health care resource utilization (HCRU), costs, and comorbidity burden immediately preceding new diagnosis of AD and 2 years after diagnosis. Methods: This study utilized a claims-based, retrospective cohort design. Medicare Advantage members newly diagnosed with AD (n = 3374) were compared to matched non-AD controls (n = 6748). All patients with AD were required to have 12 months of continuous enrollment prior to AD diagnosis (International Classification of Diseases, Clinical Modification [ICD-9] 331.0), during which time no diagnosis of AD, a related dementia, or an AD medication was observed. Non-AD controls demonstrated no diagnosis of AD, a related dementia, or a prescription claim for an AD medication treatment during their health plan enrollment. Medical and pharmacy claims data were used to measure HCRU, costs, and comorbidity burden over a period of 36 months (12 months pre-diagnosis and 24 months post-diagnosis). Results: The HCRU and costs were greater for AD members during the year prior to diagnosis and during postdiagnosis years 1 and 2 compared to controls. The AD members also displayed greater comorbidity than their non-AD counterparts during postdiagnosis years 1 and 2, as measured by 2 different comorbidity indices. Conclusions: Members newly diagnosed with AD demonstrated greater HCRU, health care costs, and comorbidity burden compared to matched non-AD controls.